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However, since then, the field has continued to progress rapidly, with recent animal studies and early-phase clinical trials that highlight the efficacy and feasibility of IN delivery for iron chelators ( 2 Impaired iron homeostasis and brain dysfunction Iron is essential for multiple biological functions, including oxygen transport, redox actions, and DNA synthesis (Khn, 2015)
In older children or adults it may be considered if there are clinical symptoms suggestive of carnitine deficiency (hypotonia, lethargy), a significant decrease in the serum free carnitine levels, an impairment in hepatic function tests, or hyperammonaemia, even in the absence of VHE
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The downside is that a 500 mcg dose requires drawing 50 units (0.5 mL), which is a larger injection volume
Because they work through different mechanisms, combining them produces a stronger and more sustained growth hormone pulse than either compound alone
Your prescriber must provide clinical justification for the compounded version
